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Thread: Breastfeeding Help & Support Needed for 32-weeker

  1. #1
    Join Date
    Apr 2008
    Posts
    32

    Default Breastfeeding Help & Support Needed for 32-weeker

    My baby was born at 32 weeks, and was in the NICU for 2.5 weeks. I started breastfeeding while she was in the NICU (although she never really latched on during that time), and pumped milk for her to be fed (first through a feeding tube, then by bottle) from day 1.
    Now that I have her home (she has been home for 2 weeks) I am trying to get her to breastfeed exclusively BUT am having some major problems. The LC and my pediatrician agree that I should breastfeed at every feeding, and offer her a supplemental bottle (except for 6 hours per day, when I should not supplement her - and obviously, this time period is to increase, until she is exclusively breastfeeding). The breastmilk she has from a bottle is enriched with 1 tsp of enfacare per 4oz, for extra calories.
    My problems right now are:
    1) Although she will latch on properly and feeds (I can see pools of milk in her mouth when she moves, and she swallows and burps), she will only latch on sometimes. Other times, she gets very fussy and agitated, and simply clamps down on my nipple (which has now made my nipples very painful, with white centers) - and even though she is wide awake, and is trying to feed, we can go for over an hour without her latching on or feeding. At that point I give up (as I'm exhausted and in agony, and she is screaming) and give her a full feeding from a bottle.
    2) For most feedings, once I get her latched on, she will feed - even if it's just for a few minutes. Once she stops all signs of interest in breastfeeding and is starting to fall asleep, I give her the 1oz bottle supplement. My question is, for the times when she won't latch on at all (when she falls asleep etc) how long should I let her go before I give her a bottle? Generally, if she falls asleep before or during a breastfeeding session, I will lay her in her crib - if she hasn't had her supplemental bottle, she will then start to fuss or cry almost immediately and will not settle.

    I am reluctant to give up breastfeeding attempts, as I can see she is making some progress, and I have a great milk supply (from 5 weeks of pumping every 3-4 hours!!) - but I am physically and mentally exhausted. Right now, when I give her bottles my husband is a great help, and feeds her while I pump, but the breastfeeding sessions (especially those in the middle of the night) usually leave us with a screaming baby, and an almost as hysterical Momma.

    Any words of wisdom or support would be greatly appreciated.

  2. #2
    Join Date
    Feb 2006
    Posts
    422

    Default Re: Breastfeeding Help & Support Needed for 32-weeker

    Quote Originally Posted by Jazzle View Post
    My baby was born at 32 weeks, and was in the NICU for 2.5 weeks. I started breastfeeding while she was in the NICU (although she never really latched on during that time), and pumped milk for her to be fed (first through a feeding tube, then by bottle) from day 1.
    Now that I have her home (she has been home for 2 weeks) I am trying to get her to breastfeed exclusively BUT am having some major problems. The LC and my pediatrician agree that I should breastfeed at every feeding, and offer her a supplemental bottle (except for 6 hours per day, when I should not supplement her - and obviously, this time period is to increase, until she is exclusively breastfeeding). The breastmilk she has from a bottle is enriched with 1 tsp of enfacare per 4oz, for extra calories.
    My problems right now are:
    1) Although she will latch on properly and feeds (I can see pools of milk in her mouth when she moves, and she swallows and burps), she will only latch on sometimes. Other times, she gets very fussy and agitated, and simply clamps down on my nipple (which has now made my nipples very painful, with white centers) - and even though she is wide awake, and is trying to feed, we can go for over an hour without her latching on or feeding. At that point I give up (as I'm exhausted and in agony, and she is screaming) and give her a full feeding from a bottle.
    2) For most feedings, once I get her latched on, she will feed - even if it's just for a few minutes. Once she stops all signs of interest in breastfeeding and is starting to fall asleep, I give her the 1oz bottle supplement. My question is, for the times when she won't latch on at all (when she falls asleep etc) how long should I let her go before I give her a bottle? Generally, if she falls asleep before or during a breastfeeding session, I will lay her in her crib - if she hasn't had her supplemental bottle, she will then start to fuss or cry almost immediately and will not settle.

    I am reluctant to give up breastfeeding attempts, as I can see she is making some progress, and I have a great milk supply (from 5 weeks of pumping every 3-4 hours!!) - but I am physically and mentally exhausted. Right now, when I give her bottles my husband is a great help, and feeds her while I pump, but the breastfeeding sessions (especially those in the middle of the night) usually leave us with a screaming baby, and an almost as hysterical Momma.

    Yay, celebrate the progress she is making with breastfeeding (BF)! She's probably right on par for her gestational age. If I read your post correctly, she's still only about 37 weeks. Between being a premie and having other oral experiences, she may need another few weeks to totally "get" it.

    The LC and pedi aren't with you and your daughter round the clock, and it's OK to trust your "instincts" and deviate at times when anyone's (including ours) suggestions don't seem to "fit" for you or your baby at the time. Your baby will get the BF as she gets a bit older -- better to deviate from the plan a bit that chuck it all because you feel you can't keep up. So do what you can do and don't stress it (any more than any new mom stresses as she learns about the 24/7 of newborn care); take a break (within reason) when too exhausted, e.g. skip a BF "practice" if latching is/seems too much of a hassle but don't skip pumping. Your baby will get it and you want milk production ready for her when she figures it all out!

    Her clamping on the nipple may be in expectation of fast flow (possibly related to the bottle nipples used) or can be related to stabilizing the breast (or bottle) in the mouth. Bottle-feeding technique and nipple/feeding-bottle-system may be more compatible with BF oral behaviors or may interfere with such.

    Re: how long to let her go when she isn't latching -- I think when either you or she is getting frustrated, that's the time to stop -- usually 5-15 minutes. Rule #1 is "Feed the Baby" and you don't want her so pooped that she can't eat as she needs to.

    You're doing a super job. Hang in... she will get better at this BF!

  3. #3
    Join Date
    Apr 2008
    Posts
    32

    Default Re: Breastfeeding Help & Support Needed for 32-weeker

    Thank you for your support. Yes, she is 37 weeks today.

    Our LC advised that we try using a breast-shield, and yesterday that worked great (for 2 feedings). Baby latched on and fed for an hour, then kept bobbing off my breast and falling asleep. But, when I put her down she started to cry and was sucking on her hands. I tried the pacifier to see if she just needed to suckle to get to sleep, but after about 20-30 minutes, when she was still crying, I gave her 1oz in a bottle - and then she fell asleep.
    How long should I be breastfeeding her for?? My hands and arms were cramping from holding her for so long, plus she was falling asleep - I thought that was a sign they were done?

    Then, to make matters worse, since then I haven't been able to get her to latch, even using the shield - so she has had bottles for her last few feeds. I'm about ready to quit - even when we have 'good' BF sessions, she is feeding for an hour, then I have to give her a bottle, then I have to pump, by which time it's almost time for her to feed again. It would be quicker and much less painful (physically and emotionally) to give her expressed milk, put her to bed, then pump - am I nuts for thinking this way?

    I guess I'm wondering if I'm doing something wrong when she does latch and feed - why would she still be hungry after BF for an hour??

    Sorry for being so miserable - I'm tired and my boobs hurt

  4. #4
    Join Date
    Oct 2007
    Posts
    50

    Default Re: Breastfeeding Help & Support Needed for 32-weeker

    Congratulations on your precious baby and your success on BF so far. And you deserve lots of . I hope you will feel better soon.

    Don't give up, it's completely worth the effots at the end. It took us some time to learn BFing together, too, but now I enjoy EVERY BFing session with my now 8mo old (4.5 mo. adjusted age) DD2.

    Having bad sessions BFing does NOT automatically means things are going downhill. When we were practicing, there was a couple of days when my DD2refused to BF 5 times or so in the row, then the next day she latched on and nursed pretty well. Maybe your baby had a bad day today. You are doing a great job, so pat your shoulder, don't take it personally and try again when you are ready again.

    One thing I noticed is that preemies do not have good stamina. Also they get sleepy pretty easily, so keeping BF sessions short seems to make sense. When my DD2 was learning to BF, I used to bottle-feed my EBM (anywhere between 1/2 oz to 1 oz) first to edge off her hunger then BF for maybe 10-25min. or so. Maybe that is something you would like to try?

    I think you mentioned in other posting that you kangaroo? Continuing to kangaroo helped DD2 to want to BF, too.

    Good luck! You are in a good hand to be in this forum.
    Last edited by wakawaka; April 11th, 2008 at 12:02 PM.
    - - - Penga (@ 32 weeks gestational) and my DH

    Mother of two girls:
    Sydney (born 10/31/01- nursed until 3 yrs & 10 mos)
    Penga (born 08/15/07 - former 25 weeker who loves to nurse)

    & no more!

  5. #5
    Join Date
    Apr 2008
    Posts
    32

    Default Re: Breastfeeding Help & Support Needed for 32-weeker

    Thanks for your advice. I think I'm going to try giving a little bottle before BF, then see if she will latch (and ulitmately settle after BF). I'll let you know how that goes.

    We are doing better with positioning on one breast (I'm right handed, and have been using the cross cradle hold). We do pretty well on the left breast, but still struggle getting comfy on the right breast. I tried doing the football hold (so that I can still hold her in my right hand/arm) but it's still far from perfect.....and that's still the side that she compresses my nipple on....causing pain.

    I'm a little confused about when each breast has been 'drained', and hope one of you can help me. When she latches (with or without shield) and feeds, after 20 minutes I check the breast (by gently squeezing the areola - which would normally result in manual expression), and if no milk comes out I switch sides. Is that the right thing to do?? Does that mean that the breast is empty/drained??
    The reason I ask is because if I pump right after BF, I still get milk from the 'empty' breast (even if I couldn't manually express any in my little test). I'm just trying to figure out how much my LO gets in each BF session - simply because she won't EVER settle after BF alone - she always needs a bottle too.
    I think it's because she gets pooped out from BF...so I think she is done (because she is falling asleep in my arms and won't latch anymore), but as soon as I put her down she starts to scream for more food.

    Any ideas or guidance would help. I'm trying not to stress over any of these BF issues, but am pretty confused.

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